Table 3. Network meta-analysis for efficacy and safety of commonly prescribed medications compared with methylphenidate.
| Pharmacological treatments | Efficacy (response) | Acceptability (all-cause discontinuation) |
Tolerability (discontinuation due to adverse events) | Serious adverse events | Decreased weight gain | Anorexia | Insomnia | Sleep disturbances (unspecified) | Anxiety |
|---|---|---|---|---|---|---|---|---|---|
| Methylphenidate | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference |
| Amphetamine | 1.42 (0.92–2.20); Very low-quality | 1.33 (0.85–2.08); Very low-quality | 1.76 (0.70–4.39); Very low-quality | 1.15 (0.20–6.72); Very low-quality | 3.37 (1.62–7.02)a; Very low-quality | 1.75 (0.95–3.31); Very low-quality | 1.79 (1.17–2.87)a; Low-quality | 0.41 (0.01–21.06); Very low-quality | 0.42 (0.02–5.72); Very low-quality |
| Atomoxetine | 0.69 (0.52–0.92)a; Low-quality | 1.45 (1.09–1.91)a; Low-quality | 1.33 (0.73–2.40); Very low-quality | 1.15 (0.40–3.50); Very low-quality | 0.71 (0.42–1.24); Very low-quality | 0.60 (0.42–0.86)a; Low-quality |
0.41 (0.30–0.58)a; Low-quality | 0.54 (0.03–2.19); Very low-quality | 0.52 (0.18–2.00); Very low-quality |
| Clonidine | 0.75 (0.36–1.58); Very low-quality | 0.68 (0.33–1.35); Very low-quality | 3.77 (0.52–32.98); Very-low quality | - | - | 0.90 (0.28–2.82); Very low-quality | 1.20 (0.43–3.95); Very low-quality | 0.21 (0.02–1.05); Very low-quality | - |
| Guanfacine | 0.62 (0.40–0.98)a; Low-quality | 1.34 (0.86–2.07); Very low-quality | 2.30 (0.87–6.16); Very low-quality | 1.45 (0.35–7.20); Very low-quality | - | 0.26 (0.12–0.57)a; Low-quality | 0.68 (0.37–1.31); Very low-quality | - | 0.70 (0.14–4.36); Very low-quality |
| Modafinil | 1.05 (0.56–2.00); Very low-quality | 1.14 (0.61–2.19); Very low-quality | 0.86 (0.21–3.75); Very low-quality | - | 0.36 (0.10–1.44); Very low-quality | 0.48 (0.20–1.14); Very low-quality | 2.47 (1.16–5.90)a; Low-quality | 0.20 (0.03–1.12); Very low-quality | 0.46 (0.08–2.38); Very low-quality |
| Bupropion | 0.46 (0.09–2.21); Very low-quality | 2.60 (0.66–11.64); Very low-quality | - | - | - | 0.68 (0.12–3.68); Very low-quality | 0.53 (0.13–1.94); Very-low quality | - | 0.50 (0.05–4.01); Very low-quality |
Results are odds ratios (OR) with 95% credible Intervals and quality of evidence. For efficacy, an OR < 1 favours methylphenidate (that is, more response events occur with methylphenidate). For acceptability, tolerability and specific adverse events, an OR > 1 favours methylphenidate (that is, fewer events occur with methylphenidate).
ap < 0.05.